A prospective analysis of immunohistochemically determined hormone receptors and nuclear features as predictors of early recurrence in primary breast cancer

Summary The immunohistochemnichally determined receptor status, as well as first-generation risk factors (tumor size, lymph node status, histologic grading including subfactors, tumor histology, and biochemically determined receptor status) were prospectively analyzed in 288 cases of primary breast cancer for their impact on recurrence-free survival (RFS) and overall survival (OS) after a median observation period of 41 months.Immunohistochemically (ER-ICA) and biochemically determined estrogen receptors (ER-DCC), as well as tumor size, lymph node status, histologic grading, mitotic rate, and nuclear polymorphism, were of prognostic value for recurrence-free survival and/or overall survival.In multivariate analysis, lymph node status, tumor size, and mitotic rate proved to be independent prognosticators; ER-ICA showed significance in the univariate analysis which dropped, however, when multivariate analysis was applied.The prognostic power of histologic grading in our series seemed to depend mainly on the subfactors which relate to nuclear features.     

Immunohistochemical Markers for Prognosis of Ependymal Neoplasms

Intracranial ependymomas are the third most common primary brain tumor in children. Although clinical and histological criteria for ependymoma prognosis are recognized, studies have reported contradictory results. Prognostic significance based on immunohistochemistry of ependymomas has been reported in a few studies. One-hundred and twelve patients with intracranial ependymomas were examined retrospectively for immuno-expression of various tumor-associated antigens and apoptosis. The results demonstrated significant preponderance of expression of the tenascin, vascular endothelial growth factor protein (VEGF), epidermal growth factor (EGFR) and p53 protein in high-grade tumors. Also high-grade ependymomas revealed more prominent labeling indices (LI) for proliferative marker Ki-S1 and apoptotic index (AI), and lower LI for cyclin-dependent kinase inhibitors p27/Kip1 and p14ARF. For low-grade ependymomas the progression-free survival time (PFS) was found to be significantly shorter for Ki-S1 LI>5%, and for tenascin, VEGF and EGFR positivity. For high-grade ependymomas PFS was found to be significantly reduced for p27 LI<20%, p14ARF LI<10%, for p53 positivity, and for AI<1%. The CART modeling process exhibited five final groups of ependymoma patients (1) low-grade and tenascin-negative; (2) low-grade and tenascin-positive; (3) high-grade and p53-negative with p14 LI>0%; (4) high-grade with combination of either p53 positivity and p14 LI>10% or p53 negativity and p14 LI<10%; (5) high-grade and p53-positive with p14 LI<10%. In summary, some immunohistochemical variables were found to be the strong predictors of ependymoma recurrence and they seem to be useful for assessing individual tumor prognosis in routinely processed biopsy specimens together with tumor grade. For histologically benign ependymomas immunohistochemical study should be focused on Ki-S1, tenascin, EGFR and VEGF evaluation, whereas p53 expression and number of p27, p14 and ISEL-positive nuclei will be of value in determining PFS from high-grade ependymomas.     

The prognostic value of histopathologic grading parameters and microvessel density in patients with early squamous cell carcinoma of the uterine cervix.

Abstract. Graflund M, Sorbe B, Hussein A, Bryne M, Karlsson M.
The purpose of this study was to investigate the prognostic importance of clinical and histopathologic factors, including malignancy grading systems (MGS), partial index (PI), invasive front grading (IFG), and microvessel density. A complete geographic series of 172 early stage (FIGO I–II) cervical carcinomas treated by Wertheim-Meigs surgery during the period 1965–1990 was studied. The patients were followed up for at least 10 years. Significant prognostic factors for disease-free survival were lymph node status ( P < 0.0000001), radical surgical margins ( P = 0.00003), and tumor size ( P = 0.008). In a multivariate Cox analysis it was shown that lymph node status was the single most important prognostic factor with regard to disease-free survival. The total MGS and the PI scores were highly significantly ( P = 0.0001) associated with pelvic lymph node metastases and disease-free survival rate in squamous cell carcinomas. The MGS and the PI systems were superior to the IFG system in predicting lymph node metastases. The total IFG score was also a statistically highly significant ( P = 0.003) prognostic factor with regard to disease-free survival in both univariate and multivariate analyses. Microvessel density was a nonsignificant prognostic factor. There was a highly significant ( P = 0.002) association between vascular space invasion of tumor cells and the presence of lymph node metastases. In conclusion, histopathologic malignancy grading systems provide valuable prognostic information in patients with early stage squamous cell carcinomas of the uterine cervix.     

240例肝穿刺活检的病理诊断与B超显像比较分析

目的:探讨B型超声显像在慢性肝炎分级分期中的作用,寻求超声检查方法对慢性乙型肝炎患者病理分级分期的诊断标准.方法:对240例慢性乙型肝炎患者B超表现与肝组织病理分级分期进行对比分析.结果:超声诊断慢性乙型病毒性肝炎的声像图征象如肝脏的包膜、实质回声、血管走形和胆囊壁的改变及门静脉、脾静脉、脾脏厚度和慢性乙型肝炎肝组织炎症活动程度显著相关(P<0.05);结论B超的声像图在评价慢性病毒性肝炎病情的轻重有重要的价值.     

经后路椎体间植骨融合椎弓根螺钉内固定治疗退行性腰椎滑脱症

目的探讨经后路减压、椎间植骨融合加椎弓根螺钉内固定治疗退行性腰椎滑脱症的临床疗效。方法本组患者35例，平均年龄59岁（49-68岁）。所有患者均行腰椎正侧位、动力位片和MRI或CI’检查。本组患者均为退变性腰椎滑脱症。滑移分度：Ⅰ°19例，Ⅱ°14例，Ⅲ°2例，其中L5/S1 27例，L4/5 8例。均表现为下腰痛，间歇性跛行或坐骨神经症状。35例全部采用后路去椎板减压、椎间融合器（Cage）植骨，椎弓根螺钉内固定术，并进行术前、术后功能和症状评分。结果随访12-35个月，平均23个月，依据x线片和临床症状恢复情况，本组患者均获骨性融合，JOA评分术前平均16．25±1．06分，术后平均24．78±1．27分，两者差异有显著性（P〈0．01），优良率94．3％。结论后路减压、椎间融合器植骨加椎弓根螺钉内固定是治疗退行性腰椎滑脱症的一种安全有效的方法，临床疗效满意。     

前列腺癌组织学分级的初步探讨

回顾性地将３７年间１４８０例前列腺活检标本中１８２例前列腺腺癌进行组织学分级与鉴别诊断的分析，其中高分化癌２５例（１３．７％）、中分化癌５９例（３２．４％）、低分化癌９８例（５３．８％）。结合文献中多种分级方案，我们采用三级分法较为简明适用。对高分化癌与增生的前列腺鉴别则以腺体结构一致，失去锯齿状以及单层上皮、核仁明显为癌性腺体的表现。     

Histologic grading at breast core needle biopsy: comparison with results from the excised breast specimen

The purpose of this study was to evaluate the correlation between histologic tumor grade obtained at breast core needle biopsy (CNB) with that obtained from the excised breast specimen. A total of 899 records from all patients with breast cancer from January 1999 to January 2003 were reviewed. Of these, 341 lesions had CNB for diagnosis and had pathology results prospectively graded for both the core and excised specimens. Patient age, lesion type and size, imaging method for biopsy, number of cores, core pathology, surgery performed, final diagnosis, nuclear grade, and combined grade were recorded. In 286 lesions (83.9%), nuclear grade was reported for both core and excised specimens. Of these, 219 (76.6%) were in agreement. Of the 67 that differed, 66 (98.5%) differed by one grade; 46 (68.7%) were upgraded. The groups did not differ in average tumor size, tumor pathology, or number of cores. In 288 lesions (84.5%), combined grade was reported for both core and excised specimens. Of these, 214 (74.3%) were in agreement. Of the 74 that differed, 71 (95.9%) differed by one grade and 50 (67.6%) were upgraded. Again, there were no significant differences in tumor size, type, or number of cores. Overall, nuclear grade and combined grade obtained at CNB each showed agreement with the corresponding excised specimen grading approximately 75% of the time. Grading obtained by CNB, if changed by pathologic evaluation of the excised tumor, is most commonly upgraded. Differences, when they occurred, could not be attributed to tumor size, type, or the number of cores obtained.     

DNA pattern and cytological findings in fine-needle aspirates of untreated prostatic tumors. A flow-cytofluorometric study

The cellular DNA content in fine-needle prostatic aspirates from 500 untreated patients was determined by flow cytofluorometry. According to the DNA patterns diploid, tetraploid, and non-tetraploid aneuploid cases were identified. In 301 cytologically benign cases more than 90% showed diploid DNA patterns. Among 166 carcinomas the incidence of aneuploid DNA values increased with the degree of anaplasia, ie, 44% in well-differentiated, 78% in moderately differentiated, and 97% in poorly differentiated tumors. In aneuploid cases of well-differentiated carcinomas almost exclusively tetraploid DNA patterns were observed, while in poorly differentiated carcinomas about 80% showed non-tetraploid aneuploid DNA distributions. Among aneuploid cases of moderately differentiated carcinomas 2/3 were tetraploid and 1/3 non-tetraploid aneuploid. Morphologically similar tumors may thus be separated by the DNA profiles. The biological significance of these results must be further evaluated by clinical follow-up of the patients.     

Are we reaching the limits or our ability to detect skin effects with our current testing and measuring methods for consumer products?

Testing for potential adverse skin effects is a key part of both the overall safety assessment for many consumer products and the evaluation of potential product improvements in mildness. Whilst modern tissue and paper products (i.e. facial tissues, catamenial products, baby wipes and baby and adult diapers) are inherently very mild to skin, current test methodology may not be robust enough to evaluate future improvements in such products. This article provides a commentary on several technologies we have been exploring to improve the sensitivity of test methods for tissue and paper products. The focus has been on three approaches: (i) further exaggerating exposure conditions using novel approaches to sample application, (ii) increasing the sensitivity of the manner in which we score for irritant effects, either visually or via instrumentation and (iii) quantitatively measuring additional endpoints, i.e. subjective sensory effects.